{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:52:26Z","timestamp":1785855146471,"version":"3.56.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Taiwan Society of Cardiology"},{"DOI":"10.13039\/100020595","name":"National Science and Technology Council, Taiwan","doi-asserted-by":"publisher","award":["113-2314-B-002-152-MY2"],"award-info":[{"award-number":["113-2314-B-002-152-MY2"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["113-M0023"],"award-info":[{"award-number":["113-M0023"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["114-M0030"],"award-info":[{"award-number":["114-M0030"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DK115392"],"award-info":[{"award-number":["R01DK115392"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL153004"],"award-info":[{"award-number":["R01HL153004"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL155834"],"award-info":[{"award-number":["R01HL155834"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary aldosteronism (PA) is a common, treatable cause of hypertension for which screening is widely recommended but rarely performed in clinical practice. However, real-world screening and diagnosis patterns across the entire hypertensive population remain unknown. This study aimed to delineate the 22-year state of nationwide PA screening and diagnosis rates among all hypertensive population in Taiwan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this nationwide retrospective cohort study from 2001 to 2022, we identified all patients with hypertension using a national health insurance database. We calculated annual PA screening and diagnosis rates, with particular focus on high-risk subgroups, including patients with resistant hypertension, early-onset hypertension, hypokalemia, and other comorbidities warranting screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 7.8 million patients with hypertension, a total of 4.4% received PA screening during the study period. The annual PA screening rate increased from 0.26% in 2001 to 0.75% in 2022 (P &amp;lt; .001) yet remained markedly low. In 2022, only 1.0% of patients with resistant hypertension, 3.2% with early-onset hypertension, and 3.6% with hypokalemia underwent screening. The diagnostic yield of PA showed a slight decrease over time, fluctuating between 8.0% and 6.7% (P = .006).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite an increase in PA screening over the past 2 decades, absolute rates remain critically low, falling far short of guideline recommendations, even in high-risk groups. Our findings quantify a major implementation gap between evidence and clinical practice. As international guidelines are shifting toward broader and simpler screening protocols, there is an urgent need to improve the detection of this common and actionable condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvag133","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T11:41:12Z","timestamp":1784893272000},"page":"194-205","source":"Crossref","is-referenced-by-count":0,"title":["Screening and diagnosis trends for primary aldosteronism: a longitudinal nationwide study of 7.8 million people"],"prefix":"10.1093","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2859-5117","authenticated-orcid":false,"given":"Cheng-Hsuan","family":"Tsai","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Hypertension, Mass General Brigham, Center for Adrenal Disorders, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]},{"name":"Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital and National Taiwan University College of Medicine , No. 7, Chung-Shan South Road, Taipei 100 ,","place":["Taiwan"]},{"name":"Primary Aldosteronism Center, Departemnt of Internal Medicine, National Taiwan University Hospital , Taipei 100 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ching","family":"Chang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center and Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch , Hsin-Chu 300 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7728-6674","authenticated-orcid":false,"given":"Zheng-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch , Yun-Lin 640 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5960-4181","authenticated-orcid":false,"given":"Stefanie","family":"Parisien-La Salle","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Hypertension, Mass General Brigham, Center for Adrenal Disorders, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]},{"name":"Division of Endocrinology, Department of Medicine, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CHUM), Universit\u00e9 de Montr\u00e9al , Montr\u00e9al, QC , H2X 0C1","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenifer M","family":"Brown","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Hypertension, Mass General Brigham, Center for Adrenal Disorders, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]},{"name":"Division of Cardiovascular Medicine, Mass General Brigham, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-9252","authenticated-orcid":false,"given":"Anand","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Hypertension, Mass General Brigham, Center for Adrenal Disorders, Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vin-Cent","family":"Wu","sequence":"additional","affiliation":[{"name":"Primary Aldosteronism Center, Departemnt of Internal Medicine, National Taiwan University Hospital , Taipei 100 ,","place":["Taiwan"]},{"name":"Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei 100 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8153-1441","authenticated-orcid":false,"given":"Yen-Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital and National Taiwan University College of Medicine , No. 7, Chung-Shan South Road, Taipei 100 ,","place":["Taiwan"]},{"name":"Primary Aldosteronism Center, Departemnt of Internal Medicine, National Taiwan University Hospital , Taipei 100 ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"issue":"12","key":"2026080410030500700_lvag133-B1","doi-asserted-by":"publisher","first-page":"967","DOI":"10.1093\/ajh\/hpac079","article-title":"Primary aldosteronism: state-of-the-art 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